Fetal Development & Movement - PDF

| WEEKLY LEARNING OUTCOMES | Explain the biomechanical interactions of the embryo and fetus with the uterine environment. Learn the developmental significance and patterns of fetal movements. Identifies pathologies related to fetal movement insufficiency. Explain the biomechan...

| WEEKLY LEARNING OUTCOMES | Explain the biomechanical interactions of the embryo and fetus with the uterine environment. Learn the developmental significance and patterns of fetal movements. Identifies pathologies related to fetal movement insufficiency. Explain the biomechanical properties and effects of pregnancy.  | ABOUT THE PREVIOUS COURSE | Today, we examined the developmental processes of the nervous system and the musculoskeletal system in the fetal period. While we learned how the nervous system develops from the first weeks of the fetus and the basic structures of the brain and spinal cord, we also evaluated the role of these structures in the development of motor skills and general nervous functions. the musculoskeletal system is shaped during the fetal period, how bones and muscles are formed, and the effects of these processes on the fetus. Also examined how muscle tone changes during the fetal period.  Kinesiology of Normal Motor Movement Kinesiology ; Greek kinesis (movement) logy (science) Kinesiology : studies human movement through the principles of anatomy, biomechanics and physiology.  Embryo, Fetus and Uterus Biomechanics The human embryo moves on a micro level long before the mother even feels the movement of the fetus. The embryo and fetus are shaped not only in a mechanical environment but also according to the mechanical force applied to it and its environment.  Embryos and fetuses are extremely small and soft  special strategies are required to measure their mechanical properties. The first fetal movement observed in humans is head and neck flexion in the 10th week. Regular body movements start from the 15th week of pregnancy. At 17-20, the mother feels it completely. A sudden decrease or increase in fetal movements  FETAL DISTRESS! Emergency.  Different forces cause linear or nonlinear deformation of embryonic or fetal structures. fetal tissues – dependent on cellular and extracellular matrix. These interactions are important in how the embryo responds.  Time-dependent dynamic development processes determine the sequence of mechanical formation. During pregnancy, the uterus expands in volume to accommodate the fetus. Cervix Allows the uterus to grow laterally. It maintains its capacity until the fetus matures. The cervix has 2 opposite functions; 1) To ensure that the fetus attaches during pregnancy. 2) To ensure the easy passage of the fetus during birth Therefore, the cervix changes in the 2nd and 3rd trimesters. There must be a 10 cm dilation for birth. Maternal contractions of the uterus -tensile load and volume changes of the cervix also pressure ↑- risk of preterm birth.  Any prolonged or systemic reduction in fetal movements may affect skeletal development. The most fatal condition is Fetal Akinesia Deformation Sequence (FADS) occurs with abnormal or absent fetal movement.  Arthrogryposis, where there are multiple joint contractures that are important in fetal movement. Especially the hip joint due to fetal movement most common developmental dysplasia of the hip (DDH) The risk of DDH is strongly linked to abnormal movement and intrauterine conditions.  Fetal Movements these patterns occur in the 15th week of pregnancy. Hiccup General body movements Isolated head and neck movements Startling and twitching movements Sucking, swallowing Isolated leg movements Stretch Breathing movements Hand-face contact Stretching and rotation  Physical Factors Affecting Fetal Movements Fetal movement other than nascent neuromuscular function: Intrauterine space Amniotic fluid amount Fetal position Male fetus  External Factors Affecting Fetal Movements The two most important external influences are; Mother's nutrition Acoustic stimulation Arthrogryposis Multiple congenital contractures A syndrome in which decreased fetal movement due to abnormal muscle or neural development is a common cause.  Hip Instability, Dysplasia or Dislocation Hip instability A tight fit between the femoral head and the acetabulum (-) Abnormal movement of the femoral head  Hip Instability, Dysplasia or Dislocation Developmental hip dysplasia and dislocation The acetabulum and the femur is unstable The femoral head is partially or completely dislocated from the acetabulum Dislocation Loss of contact between the femoral head and the acetabulum Two different dislocations; o Paralytic dislocation: Begins in the 1st or 2nd trimester Usually neuromuscular or genetic o Typical dislocation occurs in healthy babies, in utero, at birth or after birth. Pregnant Biomechanics Pregnancy is a natural process. Excess weight gain during pregnancy makes it difficult for the musculoskeletal system to adapt. These adaptations affect posture and gait. As the fetus grows, the body's center of mass shifts. Kinematic adjustments for stabilization A series of biomechanical and hormonal changes Back pain and risk of falling (+) Quality of life (-) Lordosis and kyphosis angles of the spine (+) Low back pain is due to progesterone and relaxin hormones (+) Decreased abdominal muscle strength Associated with increased anterior pelvic tilt While walking; Increased step width Decreased stride distance Slowing down the speed  Postural Changes Seen Until the Last Month of Pregnancy Increased anterior pelvic tilt Increased lumbar lordosis Gravity line shifts backwards Upper thoracic spine hyperkyphosis Shoulder protraction Anterior angulation of the cervical region Mechanical forces: affecting the development of the baby Internal and external forces are important Internal forces: Tension of tendons and ligaments, muscle contraction External forces: Gravity Genu varum at birth, towards genu valgum at 3 age.  Gross Motor During gestation , primitive reflexes appear. As the CNS develops, the infant is suppressed for goal-directed movement. Example : As long as the Asymmetric Tonic Neck Reflex continues, full rotation cannot be achieved. It is difficult to use the hand in the midline. Moro reflex impairs sitting and head control. In addition to primitive reflexes , corrective and balance- preserving reactions occur. Effective in establishing head and body balance. Reactions are effective in helping the child sit up.  Movement of both arms and legsrelated to the independent development of each limb. Walking backwards  kicking the ball occurs after the age of 2  | WHAT TO TAKE HOME? | We learned how normal motor development processes progress and how the motor skills of the fetus are formed. the embryo, fetus and uterus occur. We have detailed the developmental significance of fetal movements and movement patterns. We recognized the pathologies that develop due to lack of movement and evaluated the effects of these conditions. We learned about the biomechanical interactions between mother and fetus during pregnancy and their effects.  | QUESTIONS AND SUGGESTIONS | Which of the following hormones is associated with increased back pain due to its effects on the body during pregnancy? a) Estrogen b) Progesterone c) Testosterone d) Cortisol e) All of them  | QUESTIONS AND SUGGESTIONS | True False Biomechanical and hormonal changes can contribute to an increased risk of back pain and falls in older adults. The first fetal movement observed in humans is head and neck flexion in the 10th week. Genu varum at birth, towards genu valgum at 5 age. Patterns occur in the 18th week of pregnancy.